| Title | Fecal diversion in perirectal fistulizing Crohn's disease is an underutilized and potentially temporary means of successful treatment. | | Author(s) | Rehg KL, Sanchez JE, Krieger BR, Marcet JE | | Institution | Division of Colon and Rectal Surgery, University of South Florida, Tampa, Florida, USA. krehg@health.usf.edu | | Source | Am Surg 2009 Aug; 75(8):715-8. | | Abstract | The purpose of this study was to determine the outcome of patients treated with fecal diversion for perirectal fistulizing Crohn's disease. Thirty-nine patients were identified and followed for an average of 60 months. Patients were divided into two groups based on surgical treatment: local surgical treatment only and fecal diversion in addition to local surgical therapy. Thirteen patients (33%) underwent fecal diversion due to the severity of their disease. Eleven of these patients (85%) had complete resolution of their fistulas and only two (15%) required proctectomy. In contrast, only five out of 26 patients (19%) who underwent local surgical procedures alone had complete perirectal disease resolution. Intestinal continuity was restored in six patients (46%) and three of these patients (50%) remained disease free. The remaining three patients had disease recurrence, which required additional local procedures in one patient (17%), but with eventual resolution; the other two patients (33%) necessitated rediversion. Our data suggest that fecal diversion is a viable treatment option for severe perirectal fistulizing Crohn's disease and may be associated with a higher rate of resolution than local surgical treatment alone. In addition, we demonstrate a higher rate of successful intestinal continuity restoration than is typically reported. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 19725296 |
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